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淘豆网网友近日为您收集整理了关于3DSTE评价AMI患者心肌梗死面积及节段透壁程度的研究的文档，希望对您的工作和学习有所帮助。以下是文档介绍：3DSTE评价AMI患者心肌梗死面积及节段透壁程度的研究 分类号UDC密级——编号——.CENTRAL SOUTHUNIVE,RSITY. 。硕士学位论文论文题目:三篓墨篓遨学科专业:墅堡垦兰兰堡垦兰研究生姓名: 窒!!望堕!!量!J夏譬堡.圣苎朱文晖副教授专业技术职称:川VV’1刚'川人中南大学二0一一年五月分类号VDC硕士学位论文密级3D-STE评价棚I患者心肌梗死面积及节段透壁程度的研究Evaluating the global myocardial infarct area and segmentaltransmural extent of patients with acute myocardial infarctusing three dimensional speckle tracking echocardiography作者姓名: 刘稳刚学科专业: 影像医学与核医学学院(系、所): 湘雅三医院指导教师: 朱文晖副教授论文答辩日期塑!!二兰兰2 答辩委员会主中南大学二O一一年五月.….…………..耍3 j参……一……jj鲻:f‘≯磐i÷;;:;;!,,}(来源：淘豆网[/p-3969439.html]):{j鼍。以l:·;;;i 2‘;:n;:{:-:j上:‘÷::;l::j;yj筘o·,。‘!’:i凡;fj:ji2 jjI;:翟::;j{::、,,t;r;-,}‘,:j.170—i:‘i;;;hjj:}?j‘,i孙’;t毒:j露^;;‘·jjf一·’};歹￡《' !;;:.J;0:,!:I:i:父‘。≯f;抟t:、(,;r{.:::“:÷fjiij’i:;.‘◆’。:‘i。o毫f?÷_’I“’;i 0÷0:)_ii≯:砖:‘:i;i≯:j?:‘?:i.§-:’j’:r:j是“i¨;.:、“.·:。:心i‘‘·一。it:j .’,、:,·‘I.’’‘: ,’·‘.、‘::。·:o,:i‘··i一奠j÷rj,J●^≯1 0:‘叠,≮:i÷÷、·o,·’:垮jt曩(来源：淘豆网[/p-3969439.html]):.、j‘;㈡j..‘’0 j奠‘÷:.’嗣……~2…引j{一曩o:’0{…~一……。;i:;;::‘’i.j..、.0:…噜吖≯沁“.4囊转。吩o.,~‘,_:‘^“¨,0^一.^o锻一二oh~,q囊璩。.■.-p≮::h.矗琵黪.罄,弘t-I.‘,.避翳一^YH0嚣矗擐”强“E.;吣K;矗奠A黪裂Y弧,“奠1矗复-工4逄“焉”,,t.、~、、J^≯●叶,●.机““w一’一≯_:.●■、的地方外,论文中不包含其他人已经发表或撰写过的研究成果,也不包含为获得中南大学或其他单位的学位或证书而使用过的材料。与我共同工作的同志对本研究所作的贡献均已在论文中作了明确的说明。作者签名: 日期:丝年』月丑日学位论文版权使用授权书本人了解中南大学有关保留、使用学位论文的规定,即:学校有权保留学位论文并根据国家或湖南省有关部门规定送交学位论文,允许学位论文被查阅和借阅;学校可以公布学位论文的全部或部分内容,可以采用复印、缩印或其它手段保存学位论文。同时授权中国科学技术信息研究所将本学位论文(来源：淘豆网[/p-3969439.html])收录到《中国学位论文全文数据库》,并通过网络向社会公众提供信息服务。≥j盘K’乙/期:竺L年上月■硕士学位论文中文摘要摘要目的:以磁共振延迟强化成像(DE.MRI)技术为参考标准定量评估急性心肌梗死(AMI)患者心肌整体梗死面积及节段透壁程度,并应用三维斑点追踪成像技术比较不同梗死面积和透壁程度节段的三维应变参数的改变,找出能够反映梗死面积及节段透壁程度较敏感的指标。,:’‘方法:26fit]急性心肌梗死病人行延迟增强核磁共振(DE.MRI)扫描,以确定心肌梗死的部位、面积及乳头肌水平的梗死节段的透壁程度。①根据其梗死心肌体积占左室心肌体积百分比的大小分为大面积心肌梗死组、中面积心肌梗死组、小面积心肌梗死组。②根据透壁程度将乳头肌水平所有节段分为正常节段、非透壁梗死节段以及透壁梗死节段。应用三维斑点追踪技术分别测量左心室整体纵向收缩期峰值应变(GLS)、左室整体圆周收缩峰值应变(GCS)、左室整体径向收缩峰值应变(GRS)以及乳头肌水平各节段的纵向收缩期峰值应变(LS)、圆周收缩期峰值应变(C(来源：淘豆网[/p-3969439.html])S)、径向收缩期峰值应变(RS);同时应用常规二维超声心动图评价左室壁节段运动,计算室壁运动积分指数(WMSI),并应用Simpson双平面法计算左室射血分数(LVEF)。结果:①与小面积梗死组比较,大面积梗死组的所有整体参数和中面积梗死组的GLS、GCS的差异具有统计学意义(P&O.05),而中面积梗死组与小面积梗死组的GRS、EF和WMSI间无显著差异伊&O.05);与中面积梗死组相比,大面积梗死组除EFPI-(P&O.05),其余参数差异均有统计学意义(氏O.05)。(至)Pearson相关分析表明AMI患者左室GCS、GLS、GRS、WMSI、LVEF与M对测量的MIA相关(r产O.86,Pl&O.01;r2=0.81,P2&0.01;r3=.0.71,P3&O.01;1&4=O.64,P4&0.01;rs=.0.66,P5&O.01),随着心肌梗死MIA的增大,出现GLS、GCS、GRS及EF减低,WMSI增加的趋势,其中GL(来源：淘豆网[/p-3969439.html])S、GCS的相关性较高。③根据ROC曲线, GLS对心肌梗死面积的鉴别能力较好fMIA_&10%和MA&30%时,AUC分别为0.840、0.922)。④节段水平:与正常节段相比较,非透壁梗死节段的LS、CS明硕士学位论文中文摘要显减低(氏O.05),而RS无明显统计学差异伊&O.05),透壁梗死节段的LS、CS、RS均明显减低,差异具有统计学意义(尸&O.05);与非透壁梗死节段比较,透壁梗死节段LS、CS、RS均明显减低,差异具有统计学意义(尸&O.05)。⑤应用3D.STE分析的左心室整体纵向、圆周和径向峰值应变的组间和组内变异系数分别为1 1.24+4.38和9.54-4-4.48、 10.76+4.15和10.67-4-4.66、14.24+5.02和11.23+3.44;乳头肌水平节段纵向、圆周和径向峰值应变的组间和组内变异系数分别为13.41+5.-4-4.50、1 1.33+4.65和12.63+4.82、14.58-4-6.16(来源：淘豆网[/p-3969439.html])5n 12.43+3.94。结论:①三维斑点追踪技术参数左室整体长轴应变和整体圆周应变与心肌梗死面积密切相关,并能区分不同面积心肌梗死;②三维斑点追踪技术可间接反映局部节段的梗死的透壁程度。关键词:超声心动图,三维斑点追踪,急性心肌梗死,延迟增强核磁共振,梗死面积,透壁程度硕+学位论文英文摘要ABSTRACTobjective:To quantitative assessment myocardial infarct area andsegmental transmural extent of acute myocardial infactions usingdelayed contrast—enhanced ic resonance imaging(DE—MRI).pared the changes in three-dimensional strain parameters in differentdegree infarct area and segmental ttansmural e(来源：淘豆网[/p-3969439.html])xtent‘using threedimensional speckle tracking echocardiography(3 D—STE),to find themost sensitive indicator to reflect the myocardial infarct area andsegmental transmural extent.Methods:Twenty-six patients were examined with DE-MRI 7—2 1days after a first AMI.DE-M刚confirmed the infarct location,globalinfarct size of LV and the transmural infarct extent of each segment:@Patient were divided into groups depending on the global myocardialinfarct area:s(来源：淘豆网[/p-3969439.html])mall myocardial infarcts of&1 0%,medium myocardialinfarcts of 10%to 30%and large myocardial infarcts of&30%.②AU segments in midventricular level divided into groups dependingon the transmural infarct extent:Normal segments,Subendocardialinfarct segments of&50%and transmuralinfarct segments of&50%.LV global longitudinal peak systolic strain(GLS),LV globalcircumferential peak systolic strain(GCS),LV global radial peaksystolic strain(GRS)an(来源：淘豆网[/p-3969439.html])d LS,CS,RS of segments in midventricular levelwere measured in all subjects by 3D.STE from the apical fuII.The myocardial motion of each segment was evaluated accordingto the standard American Society of Echocardiography wall motionscoring system,which assigns a wall motion score ranging from 1 to 4 todescribe normokinesia,hypokinesia, akinesia, and dyskinesia,respectively,and wall motion scoreindex(WMSI)was calculated as theratio of the(来源：淘豆网[/p-3969439.html]) sum of wall motion score over total segments.LV ejectionfraction was assessed by Simpson’S method.The correlation betweenMIA and GLS,GCS,GRS,LVEF,WMSl were analyzed respectively.Receiver-operating characteristic(ROC)curves was used to evaluate theIII硕士学位论文英文摘要diagnostic value of quantitative parameters.Results:OCompared with small infarct group,all globalparameters in large infarct group and GLS,GCS in medium infarct grouphave significant differences(all P&0.05).No significant differences werefound in GRS,EF,WMSI between medium infarct group and smallinfarct group(all P&O.05);Compared with medium infarct group,GLS,GCS,GRS,WMSI in large infarction group have significantlydifferences(all P&0.05),but there was no significant difference in EF(P&O.05).@)Linear regression ana!ysis showed that GLS,GCS,GRS,WMSI and LVEF had asignificant correlation with the MIA(rl兰O.86,P1&0.Ol; r2=0.81,P2&0.01; r3=-0.71,P3&O.01;r4 =O.64,P4&O.0l;r5:一O.66,Ps&0.0 1 respectively).(查)According to the ROC curve,thequantitative parameter GLS was most valuable in predicting themyocardial infarct size.(MIA&1 0%.AUC=0.840;MIA&30%,AUC=0.922).④At the segmental pare with normalsegments,LS,CS reduced in medium infarct(P&O.05),but there was nosignificant difference in RS(P&O.05),LS,CS,RS in transmural segmentswere significantly decreased(P&O.05);Compared with non.transmuralsegments,LS,CS,RS reduced in transmural segments(P&0.05).⑥GLS,GCS,GRS within researchers or between researchers were11.24土4.3 8 and 9.54+4.48,1 0.76+4.1 5 and l 0.67+4.66.1 4.244-5.02 and11.234-3.44;LS,CS,RS in midventricular level within researchers orbetween researchers were 13.414-5.41 and 9.714-4.50.11.33士4.65 and12.634-4.82.14.584-6.16 and 12.434-3.94.Conclusion:(!)Global Circumferential and longitudinal strains bv3D.STE correlate with myocardial infarct area and significantlydifferentiate among 1arge,medium,and small myocardial infarcts.(至)global strain parameter from 3D.STE iS a valuable predictor of thesegmental transmural extent of myocardialinfarction.Key words: UThree dimensacutemDelay enhanced-MRI;myotransmural extent播放器加载中，请稍候...
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3DSTE评价AMI患者心肌梗死面积及节段透壁程度的研究 分类号UDC密级——编号——.CENTRAL SOUTHUNIVE,RSITY. 。硕士学位论文论文题目:三篓墨篓遨学科专业:墅堡垦兰兰堡垦兰研究生姓名: 窒!!望堕!!量!J夏譬堡.圣苎朱文晖副教授专业技术职称:川VV’1刚'川人中南大学二0一一年五月分类号VDC硕士学位论文密级3D-STE评价棚I患...
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